Laparoscopic nephroureterectomy for upper tract transitional-cell cancer: technical aspects.
Laparoscopic nephroureterectomy for upper tract transitional-cell cancer: technical aspects.
复制标题
腹腔镜肾输尿管切除术治疗上尿路移行细胞癌：技术方面。
DOI：
10.1007/978-4-431-65898-6_7
复制
发表时间：
1998
影响因子：
2.7
通讯作者：
R. Clayman
中科院分区：
文献类型：
--
作者：
A. Shalhav;A. Elbahnasy;E. McDougall;R. Clayman
大多数上尿路移行细胞癌（TCC）患者的标准治疗方法是通过两个单独的切口或一个长的腹部切口切除同侧膀胱袖状切除的全肾输尿管切除术。腹腔镜肾切除术是一种公认的形式的消融治疗良性肾脏疾病的患者，最近它已扩展到肾细胞癌和上尿路TCC的管理。1991年5月，圣路易斯的华盛顿大学进行了第一例临床腹腔镜肾输尿管切除术（LNU）。从那时起，共有20例上尿路TCC患者在我们的机构接受了LNU。该技术开始于经尿道去顶和电凝输尿管口放置外部输尿管导管。接下来，进行经腹膜腹腔镜全肾切除术或根治性肾切除术。然后，在脐下插入另一个12 mm端口，并在输尿管膀胱连接处远端切开输尿管;在膀胱袖套上击发12 mm腹腔镜GIA组织吻合器。将样本放入捕获袋中，并通过将其中一个穿刺部位扩大至7-10 cm完整取出。根据我们的经验，LNU的短期疗效与开放性肾输尿管切除术相似。然而，LNU需要平均延长3.6小时的手术时间。有利于LNU的是镇痛需求减少74%，住院时间短（平均4天），恢复快（平均2.4周）。
Standard therapy for most patients with upper-tract transitional cell carcinoma (TCC) is total nephroureterectomy with excision of an ipsilateral cuff of bladder, performed through two separate incisions or one long abdominal incision. Laparoscopic nephrectomy is a recognized form of ablative therapy for patients with benign renal disease; recently it has been extended to the management of renal cell carcinoma and upper-tract TCC. In May 1991, the first clinical laparoscopic nephroureterectomy (LNU) was performed at Washington University in St. Louis. Since then, a total of 20 patients with upper-tract TCC have undergone LNU at our institution. The technique begins with a transurethral unroofing and electrocoagulation of the ureteral orifice with placement of an external ureteral catheter. Next, a transperitoneal laparoscopic total or radical nephrectomy dissection is performed. Then, another 12-mm port is inserted infraumbilically and the ureter is dissected distally to the ureterovesical junction; a 12-mm laparoscopic GIA tissue stapler is fired across the bladder cuff. The specimen is placed into an entrapment sack and removed intact by enlarging one of the trocar sites to 7–10 cm. In our experience, LNU has had a short-term efficacy similar to that of open nephroureterectomy. However, LNU required an average of 3.6h longer operative time. In favor of LNU were a 74% reduction in analgesia requirements, a brief hospital stay (average, 4 days), and a rapid convalescence (average, 2.4 weeks).
后腹腔镜辅助肾输尿管切除术治疗上尿路上皮癌
DOI：
--
发表时间：
2006
期刊：
Eur Urol (in submission)
影响因子：
--
作者：
O.Miyake;K.Yoshimura;M.Tsujihata;et al.
通讯作者：
et al.